Nipawin - March 8, 2000 - By:Mario deSantis
   
whatever is right for somebody is wrong for somebody else A group of sophisticated health care economists have just released a position paper in which they
come to the defence of public health care by condemning the extension of private health care in
Alberta through Bill 11(1). Today, in an ever changing global village, I don't like the ideological
position of white versus black, pro-abortion versus pro-life, shoot versus not shoot, or as in our
case public health care versus private health care. If we continue to think in such a way we will
always fight for whatever is right versus whatever is wrong, and whatever is right for somebody
is wrong for somebody else. Let us have common sense as a common ground(2), and let us
recognize first that Medicare is in peril since it is taking an ever increasing taxpayers' load(3).
   
what kind of system we have to day and how we can improve it Provincial politicians and bureaucrats of any colour are saying that health care is underfunded
and they are threatening to re-dimension the health care coverage unless they get more money
from Ottawa. The re-dimensioning of health care coverage triggers opportunities for the opening
of a private health care market as it is happening in Alberta and this is why we have the current
debate of public health care versus private health care. I absolutely don't buy the abstract
contention that public health care is better than private health care, this abstract contention has no
significance unless it is within an actual health care contextual environment. So, what we have to
ask ourselves is this "what kind of system we have to day and how we can improve it."
   
linear
thinkers debating
We have shown in our past articles that most of today's economists are linear thinkers(4), that is
they analytically think that our health care world can be reduced to a system of linear equations,
where people are just numbers, for which we have to find the best analytical solutions. But we
have discovered that the best analytical solutions are not the best people's solutions(5). Now, as
long as we have linear thinkers debating what is the best health care, public or private, we, people
at large, will always be on the losing side. So, what is important is to recognize what kind of
system we have today and what kind of changes we can make to make it better.
   
health care leaders have contributed to the erosion of this system I am a simple person and I am not going to say that public health care is better than private health
care or viceversa; rather I am going to state that we have a health care system and that our health
care leaders have contributed to the erosion of this system(6). The articles published in the North
Central Internet News address the mismanagement of the present health care system, but to make
the case that health care is mismanaged I am going to refer to the sophisticated position of Dr.
Stephen Lewis, a contributing author of the above paper condemning Alberta's Bill 11 and former
CEO of the Saskatchewan Health Services Utilization and Research Commission. Dr. Lewis has
stated that we have to blow up every empty acute bed, and that we have to substitute home care for
acute care(7). He also stated that current governments have not gone far enough in cutting beds
and that we need to spend more millions of dollars in health research.
   
policy directions advocated by Dr. Lewis have been disastrous This is precisely what Dr. Lewis has advocated in Saskatchewan and what our Big Brains have
implemented in Saskatchewan. The results of these policy directions advocated by Dr. Lewis have
been disastrous. These policy directions have been the main reason to cause the shortage of nurses
by restricting the enrolment of nursing students(8); they have caused a partial shifting of the cost
to health care recipients since home care services are not fully funded; they have caused an increase
of overall public health care costs; they have caused administrative nightmares when home care
patients were forced to receive services by dozens and dozens of different health care workers(9);
they have caused atrocious working conditions for nurses, doctors, health care professionals and
all other health care workers; they have caused the funding for biased research to abscond the
mismanagement of our health resources(10).
   
health care resources are mismanaged As we have pointed out in another article, health care in Saskatchewan has been converted to a
gambling casino(11). So, when I hear Dr. Lewis saying that public health care is better than private
health care you can obviously understand where I stand, not for public health care, not for private
health care, please don't give me any crap anymore! Therefore, it makes more sense for me to state
that the present and past health care leadership has corrupted our health care system, and that health
care resources are mismanaged(12).
   
the highest priority to cure health care be placed on the proper management Further, I agree in principle with Dr. Keith Martin's point of view "that the promises of the
Canada Health Act have all, more or less, been broken... and what is covered differs from
province to province(13)" I also agree in principle with Minister Allan Rock that the health care
insured system should include standardized home care services(14). As a consequence, before
jumping into the conclusion that provinces must receive more money from Ottawa, I would
suggest that the highest priority to cure health care be placed on the proper management of health
resources, here in Saskatchewan and in any other province.
   
-------------Endnotes:
   
  General reference: Articles by Mario deSantis published by North Central Internet News http://www.ftlcomm.com/ensign/authors/desantis.html
   

1.
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Decline Klein's medicine. The Globe and Mail, March 7, 2000. Alberta's Premier has made a completely wrong diagnosis of what ails our health system, say five analysts, Robert G. Evans, Morris L. Barer, Steven Lewis, Michael Rachlis, Greg L. Stoddart. http://www.globeandmail.com/gam/Health/20000307/COMEDI.html Morris Barer and Robert Evans are professors at the University of British Columbia's Centre for Health Services and Policy Research; Michael Rachlis and Steven Lewis are health-policy consultants, the former at the University of Calgary, the latter at McMaster and University of Toronto. And Greg Stoddart is a professor at McMaster's Centre for Health Economics and Policy Analysis. Their joint report, The Deklein and Fall of CanadianMedicare?, is at http://www.chspr.ubc.ca
   

2.
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Simplicity and Clarity: A way Out of Confusion, by Mario deSantis, February 16, 2000. An excerpt "common sense, that is the discerning of whatever is important from whatever is irrelevant"
   

3.
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Brian Rourke wants more healthcare money: 40% of public expenditures are not enough, by Mario deSantis, November 14, 1999
   

4.
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The paradox of Linear Thinking has been described by the saying that "nine women can't make a baby in one month"
   

5.
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Simplicity The new competitive Advantage, by Bill Jensen, Perseus Books, January 200. An excerpt where John Seely Brown, director of Xerox's Palo Alto Research Center, is quoted as saying "The really good strategic planners I know always do it around telling stories. And the ones that I'm highly suspicious of are the ones who have the strategy emerge purely from the analytics." Page 101 http://www.simplerwork.com/j/manifesto-read.html
   

6.
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Saskatchewan Health Care: Mississippi Burning of the Year 1964, by Mario deSantis, February 25, 2000
   

7.
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Behind Closed Doors: The struggle over homecare. Research is skimpy on how much is saved, by AndrÈ Picard, The Globe and Mail http://www.globeandmail.ca/series/homecare/savings.html
   

8.
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Saskatchewan Nursing Shortage: Shifting the blame for our own Incompetence, by Mario deSantis, November 27, 1999
   

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Home care patients complain of nonstop new faces, CBC Saskatchewan, http://sask.cbc.ca/ Web Posted | Feb 4 2000 5:51 PM EST. One wheel chair patient has commented that the health system is so disorganized that she's had more than a hundred different workers in the past year.
   

10.
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Fragmented Research comes to the help of Saskatchewan Reform, by Mario deSantis, September 28, 1999
   

11.
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Pat Atkinson: raising the finger and turning healthcare to a gambling casino, by Mario deSantis, February 3, 2000
   

12.

On Mismanagement of Health Care, by Mario deSantis, March 3, 2000
   

13.
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Doc Martin's cure, National Post, March 07, 2000. Dr. Keith Martin is the Reform MP from Esquimalt-Juan de Fuca http://www.nationalpost.com/
   

14.
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PM prescribes delay on health summit, Giles Gherson, Political Editor, National Post, March 06, 2000 http://www.nationalpost.com/